WIDENING OUR LENS –Towards a new model of Psychotherapy
Irish society has undergone huge changes since the inception of the profession of psychotherapy and alongside this there have been developments in our understanding of how our minds work and there has been a growth in the areas of positive psychology and in our knowledge of the power of our thought process. This paper aims to identify some of these changes and considers how we might respond to them not only in our own practices but also in our training institutions.
One central change has been the ongoing collapse and transformation of many of the old structures and institutions whether it be that of the church, the banks, schools, charitable bodies and government bodies. There have been scandals around sexual abuse, mishandling of money and in general the misuse of power has been challenged in our society and no stone has been left unturned. There have been enquiries, exposures and tribunals all seeking to challenge old methods and structures. For those who are interested in astrology, this is explained by the fact Pluto has been in Capricorn since 2008 and thus a huge and profound structural shift has been taking place.
Authority has been challenged and is no longer an automatic right. When I grew up in the 1960’s and 70’ in Ireland we didn’t challenge the “powers that be”, whether it was the church, teacher or your parents at home. I can remembering seeing my brothers who were altar boys get slapped on the altar and when I raised it at home, I was silenced and I quickly learned that I had said something considered to be inappropriate. There was no support for me to challenge this priest and my family were not going to cause trouble either . This was of course representative of society at the time and there were much more severe examples of the abuse of power in the church and throughout the wider society. The status quo was generally one of acceptance, resignation and a belief that really we had very little control over our own destiny. An indepth analysis of this culture is not within the remit of this paper, other than to say we had a history of colonialism and oppression by church and state.
Whilst we may still not have arrived at the pure, transparent and inclusive society we would like,and there are still ongoing changes, we are in my view more empowered in terms of people having a voice , finding ways to demonstrate their dissatisfaction and challenging authority and ongoing corruption. In schools, parents demand to be more involved, those working in institutions are acutely aware that they are in the public eye and need to be mindful of their actions and how they treat residents. Institutions seek to be more accountable and society is demanding this. Society has been and is being “cleaned out”. The new paradigm, is one of empowerment and participation and increasingly people are seeking to develop greater agency and control over their own lives. There is more openness to how mind, body and spirit are connected and I am continually amazed and encouraged how yoga classes, pilates classes and mindfulness classes are in such demand. People are breathing into their heart chakras, practising visualisation and thinking positive thoughts and really wanting support to effect change in themselves and to keep themselves well.
Developments in Neuro science
One of the key developments that has impacted on psychotherapy is the area of neuroscience as it allows us as therapists to provide an explanation of how therapy works. The field of neuroscience shows that all our thoughts, feelings, memories and sensations can be attributed to the neuron cells in our brain passing messages along synapses or neural pathways. We know that when neurons connect they form a bond and we tend to get into habits of passing messages along well used pathways. But these neuro pathways in the brain can be changed and that the brain is in fact a dynamic structure rather than a fixed one. Throughout our lifespan new neural pathways can be developed and new neurons can be built and our brains can rewire themselves and psychotherapy can effect this kind of change. Neuroscience also gives us an understanding of trauma and the role of therapy. Cozolino (2015), in his recent publication “Why Therapy Works” explains that many of our human issues which are brought to therapy have arisen because of how we process utilising different aspects of our brain. When our brain needs to react quickly to alert us to potential dangers, it is our fast primitive/reptilian brain which is called in to play rather than our slower part of the brain in the frontal cortex which helps us to plan reason and negotiate. Early painful childhood experiences, especially, can be difficult to integrate and are traumatic as we process much in early life through the our fast, reptilian brain and our frontal cortex which can plan, reason and negotiate social relationships only develops later. These early experiences can wreak havoc on our world view and make us feel unsafe. He argues that a good therapist can utilise the basic human need for connection, be a positive parental figure and help clients calm their over active primitive brain response, uncover unconscious patterns of thought and behaviour and alter the neural patterns to create healthier functioning. Neuroscience demonstrates that we can change and that our tendency to repeat behaviours can be modified. It is also interesting to note that it explains that we all have a predisposition to focusing on negative as our brains evolved with a requirement to be alert to what was fear inducing rather than situations causing us to feel relaxed and well.
Positive psychology makes a huge contribution to the field of wellness and can be described as the study of happiness. Seligman (2003), one of the founders of Positive psychology believes that happiness has to be more than the absence of misery and that psychotherapy needs a whole set of other skills that are about more than delving into our issues and releasing the pain. He believes that we need to learn and to teach the skills of being a happy and how to live well. Positive psychology focuses on wellness and provides us with concrete ideas , scientifically proven , to promote and maintain wellness. Seligman believes that whilst pain and suffering addressed in therapy is important we have gone too far. Acknowledging pain and suffering are important but we all still need to be able to find meaning, experience gratitude and be happy. Skills of being happy need to be grafted on to our in depth work with clients .
Key concepts in the area of positive psychology concern themselves with helping people maximise their potential, to find ways to engage with their highest strengths and also to seek to find ways to find meaning and to connect with a bigger purpose. Seligman has done extensive studies on how our strengths correlate with happiness and interestingly noted that our capacity to love and be loved have the highest statistical correlation with life satisfaction and happiness. He promotes expressing gratitude and caring for others as activities which will really make us feel better and reduce depression
There has been a huge surge in interest in mindfulness and there is widespread recognition of how powerful the practice can be whether as an everyday practice to support our well being or one specifically geared to help us manage pain, illness or a particular psychological issue. Mindfulness is now in the “ether” and people inherently seem to understand its value in this fast paced, post religious society we live in. Many psychotherapists further their training by studying mindfulness and are aware of the value for their clients in terms of increased sense of well being. Studies such as Davidson,R.J. et al (2004) demonstrate that those who regularily practice mindfulness are happier and more contented than average as it can enhance the area of the brain associated either happiness and compassion. Mindfulness can assist us in managing and living in greater harmony with our minds. We can learn to observe our minds and Buddhist teacher Yongey Rinpoche (2007) describes that the “mind is a kind of constantly evolving occurrence arising through the interaction of neurological habits and the unpredictable elements of immediate experience.” Mindfulness is an approach to helps us become aware of this and to develop a relationship with ourselves.
Consciousness creates reality
Our thoughts, awareness and intentions all influence not only how we perceive but also our reality. Physicists do now acknowledge that there is an observer effect and this was acknowledged in the 1930’s by pioneering physicist Sir James Jeans who wrote “the steam of knowledge is heading towards a non mechanical reality; the universe begins to look like more a great thought than like a great thing”. Many people are embracing this way of understanding reality and it has been popularised by the best selling film and book The Secret. Essentially they promote the view “be careful what you wish for”. That we are co-creators of our own reality and we have much more choice than we realise. If we practice affirmations and expecting good things to happen they will. That our thoughts are more powerful than we realise.
The biologist Bruce Lipton in his book The Biology of Belief (2005) demonstrates his then controversial discovery that the energy from our thoughts influences our very cells and that essentially our bodies can be changed as we re train our thinking. This concept is I believe a view that is being incorporated with very little effort into current main stream thinking. He believes we have been programmed to feel powerless especially in the area of health and spirituality and that we are entering a new era which is based on love rather than fear and that increasingly we can shape our lives to be more, healthy loving and fulfilled by taking control of our thought patterns .
What are the implications of all of these changes ?
In some sense psychotherapy fits beautifully into this new paradigm in that our core values embody personal responsibility, cultivating awareness and supporting the client take better charge of their own lives.
More Empowered Clients
In my view clients will and must be more empowered in coming to therapy. No longer do they come to a psychotherapist who is a “blank canvas” as it is likely that they have looked us up online and got some background. We need to ensure that the information they find is the information we wish them to find! It will be helpful if are able to articulate clearly what we do and how it has been shown to work? We will be competing with other therapies in that there are many people offering different forms of healing and so we will need to be able to be able to identify clearly what we are offering and perhaps what the benefits are likely we be.
We will also be competing with offers of instant healing online such as “Heal your inner critic” in just 10 minutes per day for 14 days, and podcasts and U tube videos on how to have a happier life.
As we have been steadily and at times dramatically clearing out old structures and outworn view points, it is likely that more clients will be preparing to move forward more and do less of looking back. This is clearly an optimistic and perhaps controversial statement and may not rest well with everyone, but as a society we have done a lot of healing and whilst there are still hurts and injustices it is important we can support clients in moving on and building health. This is not to say that there are still of course clients who will need indepth healing due to early traumas or help to deal with serious life issues, but that our context has changed and is changing.
Value of both short term and long term work
Neuroscience gives us a framework to understand the changes that can occur in our clients lives and can be used to support both term work and more longer term. Cozolino (2015) , is not categorical about the length of therapy nor the type of therapy and instead focuses on what we seek to achieve as therapists; a good relationship that clients can feel safe enough to let go misperceptions of themselves and try out new behaviours to assist them in healing.
Long term therapy may be vital for unconscious, deep seated issues but shorter term interventions can make an impact if there are issues that rely on explicit memories that are in our conscious mind. Whatever we repeatedly sense, feel and think will slowly sculpt our neural structure. Ivey and Zalaquett (2011) also argue that we can feel and think differently by focussing using our rational mind and they caution against focus on negative issues and re inforcing these brain circuits and instead suggest we use our rational, frontal cortex to focus on positives and strengths and that this can overcome the negative
Role of Positive Thinking
Writers such as Ward and Stokes (2014) argue that if we practice visualisations and expressing positive emotion we will eventually feel positive and will change the brain chemistry. Solution focussed therapy was developed by Steve De Shazer in the 1980’s and offers a helpful way for a client to really see and imagine their way forward in their lives. He suggests we use the “miracle question” which could be in the form of : “If a miracle were to happen and you woke up tomorrow morning and your life had been transformed in a positive way what would have happened, how would you feel?” This kind of enquiry encourages our client to become their own expert and begin to seeks ways to make their lives better themselves. Its not a new approach but could be helpful if we are seeking to offer a more short term focussed intervention.
The implications of the thesis that our thoughts create our reality are far reaching and the extent to which we can integrate this into our work with clients would depend on both the client and therapist.
Techniques such as “tapping” that work directly with energy are already being practiced by some psychotherapists in their work with clients. This is a technique that is based on the principles of ancient acupressure and modern psychology and in a very practical way is used to heal any negative emotions or physical pain. The method used is that of tapping with your fingertips on specific meridian points of your body, including your hands, temples, forehead, etc., while focusing on negative emotions or physical sensations. Advocates argue that when you combine this technique, with vocally speaking affirmations and positive words, our nervous system can become calmer and our bodies can be brought back to balance. David Feinsten, a well recognised clinical psychologist from the John Hopkins University School of Medicine has done extensive research on how the process works and how our nervous sytem can be de activated and undesired responses can be uncoupled from the triggers. providing you with greater ease and freedom to live your life more effectively and joyfully. He argues that one of the strengths of this approach is that is fast and precise and that “right there in the moment, the entire landscape of the brain is changing around the issue that the person is thinking about.”
Whilst some clients may be on anti depressants or some form of medication prescribed by their medical practitioner, there is an increasing awareness of other “complementary” healing interventions. One such approach is homeopathy and this is working at an energetic level and can very safely and effectively support our work as psychotherapists. Homeopathy views illness as something which ‘arises’ when the individual is out of balance on either a physical, mental, emotional or spiritual level. Homeopathy is a very deep medicine which can effect us on these different levels and can be used effectively in conjunction with psychotherapy and there already psychotherapists offering this in addition to their practice of psychotherapy.
Psychotherapy may embrace broad based therapists such as those who practice eco psychotherapy and who have a strong belief in the healing power of nature. Theodore Roszak “Other therapies seek to heal the alienation between person and person, person and family, person and society. Ecopsychology seeks to heal the more fundamental alienation between the recently created urban psyche and the age-old natural environment”. Theodore Roszak Dublin based David Staunton describes himself as an eco psychotherapist and his approach is to include, explore and restore the human-to-nature connection as well as the human-to-human relationship. He meets clients initially indoors but if they wish will then subsequently meet them outdoors.
As I have already discussed, we practice in a society that is rapidly changing. Our clients are and will be increasingly seeking out a variety of approaches to feeling well. We need to ensure our professionalism and standards of practice in psychotherapy. However, there are a myriad of influences on clients wellness. The positive psychology movement argues that by expressing gratitude and caring for others we can feel better. But the be careful what you wish for approach, espoused by thinkers such as those in The Secret, take this further in that the underlying belief is that we can change our external reality with our thoughts. We can’t be seen to be being woolly or esoteric in our approaches. Alongside this, in my view clients are increasingly aware that their thoughts can change their reality. At the moment, society does seem ready to accept the positive psychology contributions around how we can improve our well being. However, the concept that we can change our external environment may not still be a fully credible proposal for therapy to embrace. Does our profession need to maintain a conservatism to ensure credibility ?
The therapeutic relationship has always been of paramount importance and in my view will continue to be. In particular, therapist qualities of authenticity, transparency and courage as always will continue to be highly prized. However, I do believe its important we seek to acknowledge and support our clients in their strengths and in moving forward in their lives.
In my own practice, I enquire at the outset whether clients wishes to engage in short term or longer term work with me. I am clear that both have a role. I also am very open to other aspects of the clients well-being such as exercise, diet and whether they may benefit from practices to support them such as yoga or mindfulness. Generally they are bringing this up in our conversations. I am interested in other inverventions to support energetic shifts such as homeopathy and in my own direct experience have found this to be a very helpful addition to the psychotherapy process.
It is an exciting time for psychotherapy. Our values of empowerment and client self determination fit beautifully within this new paradigm in society but we must ensure we stay open to societal changes in building wellness and seek to incorporate these changes into our practices.
Monica Haughey March 2016
Byrne, Rhonda “The Secret” Atria Books 2006
Cozolino, Louis “Why Therapy Works- Using Our Minds To Change Our Brains “ W.W. Norton & Co. (2015)
Davidson, R.J et al “Alterations in Brain and immune function produced by Mindfulness Meditation” Psychometric Medicine 65(2004) 564-70 In Yongey Mingyur Rinpoche (2007) “The Joy of living, Unlocking the Secret and Science of Happiness
Jeans, James The Mysterious Universe 1930
Feinsten, David “The Promise of Energy Psychology” 2005
Lipton, Bruce “The Biology of Belief” Hayhouse Press 2005
Roszak, Theodore “The Voice of the Earth: An exploration of Ecopsychology” 2001
Seligman Martin E.P. “Authentic Happiness” Nicholas Brealey Publishing 2003
Staunton , David www.walkinniu.ie
Ivey, Allen E. and Zalaquett , Carlos P. in Journal for Social Action in Counselling and Psychology Spring 2011
Yongey Mingyur Rinpoche “The Joy of living, unlocking the Secret and Science of Happiness”. Bantam books 2007
Ward,K. and Stokes, H. “The Happy Map – your road map to the habit of happiness” Bonsai Press 2014
De Shazer, Steve “ Clues; Investigating Solutions in Brief Therapy”. W.W. Norton & Co 1988